Vital Statistics Form

Please fill this form out as much as possible. It will help us to complete the death certificate and in writing the obituary. All fields with an asterisk are required.

Deceased's Information

If residence, please include address
mm/dd/yyyy
English, Irish, French, German, etc.
Be specific
Primary occupation during working years. *Do not enter \"retired\".
Sales, Medical, Engineering, Construction, etc.
Please list survivors and relationship: son, daughter, brother, sister, etc.
Religious affiliations, fraternal and civic organizations, hobbies, etc.

Informant's Information

A copy of what is submitted will be sent to this email.
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Obituaries & Condolences

Donald L. Shriver

Brian Delaney

Lynn Vernon (“Vern”) Krehbiel

Thomas J. Sweeney

Patricia M. Marschel

Betty Jane Creath

MAGGIELEE DELAHANTY

Carolyn Heller McCaul

George Robinson Jenkins

Sarah Neill Cornish (Sally)

John F. Henry

Meloa Kay (Anderson) Gallup